Does R93.6 require prior authorization?

No, R93.6 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R93.6` — Abnormal findings on diagnostic imaging of limbs

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Verify and document compliance with applicable NCCI edits and OPPS packaging rules prior to billing.
Include a valid ICD-10-CM diagnosis code on the claim that best describes the patient's condition for which the heavy metal test was performed.
For diagnostic heavy metal tests, report the test result on the claim if known; if the result is not known, report the symptoms that prompted the test.
When required, report the referring/ordering physician's name and NPI on the claim.

MRA (with or without contrast) is covered when it can replace a more invasive diagnostic test (e.g., contrast angiography) and thereby reduce risk to the beneficiary.
MRA is covered for diagnosis and assessment of diseases and abnormalities of the arterial, venous, and lymphatic systems at any anatomic location when reasonable and necessary for the specific patient's diagnosis or treatment.
Coverage and definition of MRA are subject to the CMS Internet-Only Manual, Pub. 100-03, Medicare NCD Manual, Chapter 1, Part 4, §220.2; MRA is considered appropriate consistent with that NCD.
Serum thallium testing is covered for beneficiaries with documented industrial thallium exposure and unexplained ataxia.
Serum tin testing is covered for beneficiaries with documented industrial tin exposure.
Serum aluminum testing is covered for beneficiaries on chronic dialysis with evidence suggesting aluminum toxicity or for beneficiaries with documented chronic industrial aluminum exposure.

A56767 — Billing and Coding: Heavy Metal Testing

J06

L35074 — Heavy Metal Testing

J06

A59845 — Billing and Coding: Magnetic Resonance Angiography

A56775 — Billing and Coding: Magnetic Resonance Angiography

L34424 — Magnetic Resonance Angiography

Ask Verity about documentation requirements, denial risks, or coverage in your state.